Healthcare Provider Details

I. General information

NPI: 1578069167
Provider Name (Legal Business Name): DANIEL CHOI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 11/26/2020
Certification Date: 11/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6466 S HIGLEY RD STE 101
GILBERT AZ
85298-4335
US

IV. Provider business mailing address

1471 E DANA PL
CHANDLER AZ
85225-2021
US

V. Phone/Fax

Practice location:
  • Phone: 480-457-8283
  • Fax:
Mailing address:
  • Phone: 510-468-9038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number10342
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number10577
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: